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f � <br /> CITY OF ORONO * z 0 1 4 - 0 0 4 2 1 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: OS/08/2014 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 1565 MAPLE PL <br /> PIN : 08-117-23-33-0031 <br /> LEGAL DESC : CRYSTAL BAY VIEW <br /> : LOT 009 BLOCK 006 <br /> PERMIT TYPE : SEWER <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : CONNECTION <br /> NOTE: NEW Si:WGR CONNEC"I'ION <br /> APPLICANT SEWER CONNECT/DISCONNECT/REPA[R 50.00 <br /> STATE SURCHARGE SEWER& WATER 5.00 <br /> J P SCHMI"I'Z CONSTRUCTION COMPANY LL TOTAL 55.00 <br /> 16450 1 17TH AVE N <br /> MAPLE GROVE, MN 55369- Payment(s) <br /> CHECK 11566 55.00 <br /> OWNER <br /> Maple Place LLC <br /> 550 25TH AVE N <br /> ST. CLOUD, MN 56303- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall bc performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant pennission for additional or related work which requires separ2te <br /> permits. All provisions of laws and ordinances governing[his type of work <br /> shall bc compied with whether or not specified herein.This permit will <br /> expire and bccomc null and void if construction authorized is not <br /> commenced within I 80 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked y for due c <br /> � / l/ / <br /> Applicant Permitee Signature Dat� Issued y Signature Date <br />